Bilirubinuria Test Methods
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Questions and Answers

What are the two primary causes of bilirubinuria?

Obstruction of bile outflow and hepatocellular disease.

How can gallstones contribute to bilirubinuria?

Gallstones can block the common bile duct, leading to obstruction of bile outflow.

What is the effect of acute viral hepatitis on bilirubin levels?

Acute viral hepatitis may lead to an increase in bilirubin levels, often preceding symptoms like jaundice.

Which genetic conditions are associated with bilirubinuria?

<p>Dubin-Johnson syndrome and Rotor syndrome.</p> Signup and view all the answers

Why is bilirubin not found in Gilbert's disease?

<p>Gilbert's disease does not cause significant impairment in bilirubin excretion, allowing bilirubin levels to remain normal.</p> Signup and view all the answers

What is the significance of using diazotized 2,4-dichloroaniline in the Multistix urine test?

<p>It is used as a diazo salt that allows detection of bilirubin through a color change, indicating the presence of bilirubin in urine.</p> Signup and view all the answers

How does the time required for color change differ between Multistix and Chemstrip tests?

<p>Multistix shows a color change within 20 seconds, while Chemstrip requires 30-60 seconds.</p> Signup and view all the answers

What factors might lead to false-negative results in bilirubin testing using these strips?

<p>False-negative results can occur due to bilirubin oxidation from exposure to light or prolonged storage of urine.</p> Signup and view all the answers

How do large amounts of ascorbic acid affect the results of the urine bilirubin test?

<p>Large amounts of ascorbic acid lower bilirubin levels, potentially leading to misleading test results.</p> Signup and view all the answers

What is the impact of drug metabolites, such as those from phenazopyridine, on the test results?

<p>Drug metabolites like phenazopyridine can create a reddish color that masks the test results.</p> Signup and view all the answers

What are the typical urine characteristics associated with bilirubinuria?

<p>Bilirubinuria is associated with yellow-brown to greenish brown urine that may have a yellow foam.</p> Signup and view all the answers

How does a positive test for urinary bilirubin and a negative test for urobilinogen help in diagnosis?

<p>It indicates intrahepatic or extrahepatic biliary obstruction, helping differentiate the causes of jaundice.</p> Signup and view all the answers

What does the presence of pale-colored feces indicate in relation to bilirubin?

<p>Pale-colored feces, or acholic stools, indicate an absence of bilirubin-derived pigment due to biliary obstruction.</p> Signup and view all the answers

Explain the method by which the reagent strip detects bilirubin in urine.

<p>The reagent strip test utilizes a coupling reaction of bilirubin with a diazonium salt in an acid medium.</p> Signup and view all the answers

Why is bilirubinuria not found with hemolytic jaundice?

<p>Bilirubinuria is absent in hemolytic jaundice because the bilirubin produced is largely unconjugated and not excreted in urine.</p> Signup and view all the answers

Flashcards

Diazotized 2,4-dichloroaniline

A chemical compound used in Multistix urine test to detect bilirubin. It reacts with bilirubin, producing a color change from cream-buff to tan within 20 seconds, indicating a concentration of 0.8 mg per deciliter of urine.

2,6-dichlorobenzene-diazonium tetrafluoroborate

A chemical compound used in Chemstrip urine test to detect bilirubin. It reacts with bilirubin, producing a color change from pink to violet in 30-60 seconds, indicating a concentration of 0.5 mg per deciliter of urine.

Free bilirubin

The breakdown product of bilirubin in urine, less reactive than the original form. Its presence can result in false-negative bilirubin test results.

Phenazopyridine (Pyridium)

A compound that can interfere with bilirubin test results by creating a reddish color that masks the actual bilirubin levels.

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Interfering substances in bilirubin tests

Substances that can interfere with bilirubin test results by either lowering bilirubin levels or causing false-positive results.

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Bilirubinuria

The presence of bilirubin in the urine, often seen as yellow-brown to greenish-brown urine, indicates an issue with the liver or bile ducts.

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Acholic stools

Acholic stools are pale-colored feces that lack bilirubin-derived pigment, which is due to the absence of bilirubin breakdown products in the intestines.

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Obstructive jaundice

This type of jaundice, unlike hemolytic jaundice, is characterized by the presence of bilirubin in the urine.

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Diazonium salt reaction

A chemical reaction where bilirubin reacts with a diazonium salt in an acidic environment to produce a color change, indicating the presence of bilirubin.

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Urine bilirubin test

This test helps distinguish between different causes of jaundice by assessing the presence or absence of bilirubin in the urine.

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What is bilirubinuria?

Bilirubinuria is the presence of bilirubin in the urine. It's a sign that something is wrong with the liver's ability to process bilirubin.

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What is a primary cause of bilirubinuria?

One of the main causes of bilirubinuria is an obstruction in the bile duct, either within the liver (intrahepatic) or outside the liver (extrahepatic). This obstruction prevents the normal flow of bile, leading to a backup of bilirubin.

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What is another primary cause of bilirubinuria?

Another primary cause of bilirubinuria is hepatocellular disease. This means the liver cells themselves aren't working properly and can't effectively eliminate conjugated bilirubin into the bile.

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How can gallstones cause bilirubinuria?

Gallstones can cause bilirubinuria by blocking the common bile duct, preventing the proper flow of bile.

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How can hepatitis cause bilirubinuria?

Hepatitis, especially acute viral hepatitis, often precedes jaundice and can lead to bilirubinuria. This is because viral infections can damage liver cells and affect their ability to process bilirubin.

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Study Notes

Bilirubinuria Test Methods

  • Multistix uses diazotized 2,4-dichloroaniline as the diazo salt.
  • Color change from cream-buff to tan at 20 seconds.
  • Detects 0.8 mg per deciliter urine.
  • Chemstrip uses 2,6-dichlorobezene; color changes from pink to violet at 30-60 seconds.
  • Detects 0.5 mg per deciliter urine.
  • Test must be fresh.
  • Quickly hydrolyzes to less reactive form.
  • Specimens exposed to light give false-negative results.
  • Large amounts of ascorbic acid and nitrite lower bilirubin.
  • Metabolites of drugs such as phenazopyridine (Pyridium) give a reddish color at low pH.
  • Rifampin and large amounts of chlorpromazine mask the result.
  • Salicylate metabolites do not interfere.
  • Urobilinogen does not affect the result.

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Description

Explore the different methods used to test for bilirubinuria, focusing on the specifics of the Multistix and Chemstrip methods. This quiz covers essential details such as color changes, detection limits, and factors affecting the test results. Test your knowledge on this important aspect of urine analysis.

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